What this fact pack is for This fact pack gives a broad overview of the Be Be Mobile initiative and how it fits into the 2030 Sustainable

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4 What this fact pack is for This fact pack gives a broad overview of the Be He@lthy, Be Mobile initiative and how it fits into the 2030 Sustainable Development agenda

5 I firmly believe that technology has a pivotal role to play in helping the world achieve Universal Health Coverage WHO and ITU are successfully using ehealth to address non-communicable diseases and risk factors via their mobile phones Dr Tedros Adhanom Ghebreyesus Director-General the World Health Organization

6 The joint partnership between ITU and WHO provides an opportunity to transform how health care is delivered and accessed worldwide. Incorporating ICTs in the health sector will greatly contribute to the attainment of the 2030 Agenda for Sustainable Development Brahima Sanou Director Telecommunication Development Bureau of ITU

7 Contents 1. NCDs: a global challenge 7 2. The rise of the mobile phone NCDs and digital health at the UN Be He@lthy Be Mobile BHBM pillar one: handbooks BHBM pillar two: countries BHBM pillar three: partnerships BHBM programme results BHBM programme innovations 113

8 6 SECTION ONE

9 NCDS: A GLOBAL CHALLENGE 7 1. Noncommunicable diseases: a global challenge

10 8 SECTION ONE Noncommunicable diseases Heart disease and stroke Noncommunicable diseases (NCDs) and their risk factors Risk factors Tobacco use Unhealthy diets Physical inactivity Diabetes Cancer Chronic lung disease Harmful use of alcohol

11 NCDS: A GLOBAL CHALLENGE 9 NCDs cause more deaths than all other causes combined NCD deaths are projected to increase from 38 million in 2012 to 52 million by 2030 Over 80% of NCD deaths happen in developing countries Probability of dying from the four main noncommunicable diseases between the ages of 30 and 70 years, comparable estimates, Probability of dying from four main NCDs* (%) < Data not available Not applicable * Cardiovascular diseases, cancer, chronic respiratory diseases and diabetes Source: WHO, Global status report on noncommunicable diseases WHO 2014, All rights reserved. Data Source: World Health Organization Map Production: Health Statistics and Information Systems (HSI) World Health Organization kilometers The designations employed and the presentation of the material in this publication do not imply the expression of any opinion whatsoever on the part of the World Health Organization concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. Dotted and dashed lines on maps represent approximate border lines for which there may not yet be full agreement.

12 10 SECTION ONE 9 global targets to be attained by 2025 A 30% relative reduction in prevalence of current tobacco use A 30% relative reduction in mean population intake of salt/sodium Halt the rise in diabetes and obesity A 25% relative reduction in risk of premature mortality from cardiovascular disease, cancer, diabetes or chronic respiratory diseases At least a 10% relative reduction in the harmful use of alcohol

13 NCDS: A GLOBAL CHALLENGE 11 At least 50% of eligible people receive drug therapy and counselling to prevent heart attacks and strokes A 25% relative reduction in prevalence of raised blood pressure or contain the prevalence of raised blood pressure A 10% relative reduction in prevalence of insufficient physical activity An 80% availability of the affordable basic technologies and essential medicines, incl. generics, required to treat NCDs

14 12 SECTION ONE Cost of inaction US$ 7T The cumulative lost output in developing countries associated with NCDs between Cost of action US$ 170B The overall cost for all low and middle income countries to scale up action by implementing a set of best buy interventions between 2011 and 2025, identified as priority actions by WHO Reports are available at

15 NCDS: A GLOBAL CHALLENGE 13 NCDs at the UN: For the second time in United Nations history, the UN hosted a high-level summit on a health issue NCDs were acknowledged as an international health priority Call for innovation and public-private partnerships

16 14 SECTION TWO

17 THE RISE OF THE MOBILE PHONE The rise of the mobile phone

18 16 SECTION TWO Raising your voice:

19 THE RISE OF THE MOBILE PHONE 17 the development and progress of the telephone

20 18 SECTION TWO >7 billion mobile subscriptions globally In 2015, 95% of the world had mobile network coverage

21 THE RISE OF THE MOBILE PHONE 19 What is mhealth? Medical and public health practice supported by mobile devices, such as mobile phones, patient monitoring devices, personal digital assistants (PDAs), and other wireless devices (Global Observatory for ehealth, 2011)

22 20 SECTION TWO What is mhealth? 1. Client education & behaviour change communication (BCC). 2. Sensors & point-of-care diagnostics 3. Registries / vital events tracking 4. Data collection and reporting 5. Electronic health records 6. Electronic decision support Information, protocols, algorithms, checklists 7. Provider-to-provider communication User groups, consultation 8. Provider workplanning & scheduling 9. Provider training & education 10. Human resource management 11. Supply chain management 12. Financial transactions & incentives

23 THE RISE OF THE MOBILE PHONE 21 Why mhealth? Mobile phone subscriptions versus population: billion subscriptions vs 7.5 billion people

24 22 SECTION TWO Why mhealth? More people have access to mobile phone than clean water or toothbrushes

25 THE RISE OF THE MOBILE PHONE 23 Advances in mobile phone and wearable devices means we can record and use our own data for health and behaviour change

26 24 SECTION THREE

27 NCDS AND DIGITAL HEALTH AT THE UN NCDs and digital health at the United Nations

28 26 SECTION THREE The SDGs represent an integrated set of goals that emphasizes cross-sectoral development. These SDGs are important for all UN agencies and determine a number of specific targets for each overall goal.

29 NCDS AND DIGITAL HEALTH AT THE UN 27 The changing face of global health Previous focus of global health Communicable diseases Vertical programs Disease management Post-2015: the changing agenda Move from vertical to comprehensive programs (holistic health) Universal health coverage Disease prevention, especially noncommunicable diseases

30 28 SECTION THREE mhealth and the Sustainable Development Goals Mobile technologies have the potential to play an important role in advancing universal health coverage and are well-positioned to contribute to the achievement of many of the Sustainable Development Goals (SDGs)

31 NCDS AND DIGITAL HEALTH AT THE UN 29 mhealth to support NCDs (SDG 3.4), Universal Health Coverage (3.8) and tobacco control (3a) through: Behaviour change communication Data collection Health worker training Reminders Empowering women

32 30 SECTION THREE Be Be Mobile is supporting SDG 9 by: Encouraging ministries of health and technology to work together to deliver health services using ICT infrastructure Fostering national innovation by supporting technology development, research and innovation in developing countries (SDG 9.b)

33 NCDS AND DIGITAL HEALTH AT THE UN 31 Be Be Mobile is supporting SDG 11 by: Supporting mhealth programmes at the individual level, municipal level, and the national level

34 32 SECTION THREE Be Be Mobile is promoting partnerships for sustainable development through: A multisectoral partnership models for mhealth (SDG 17.17) Horizontal collaboration between countries to share knowledge and expertise (SDG 17.6)

35 NCDS AND DIGITAL HEALTH AT THE UN 33 mhealth and NCDs at WHO WHO resolutions have recognized the centrality of NCDS and digital health to the core work of the organization WHO declarations on NCDs and digital health from include: Resolution WHA Resolution WHA Resolution A/RES/66/2 Resolution EB 139/8 Resolution WHA Draft resolution for WHA 71 EXECUTIVE BOARD EB139/8 139th session 27 May 2016 Provisional agenda item 6.6 mhealth: use of mobile wireless technologies for public health Report by the Secretariat 1. Mobile technologies are becoming an important resource for health services delivery and public health due to their ease of use, broad reach and wide acceptance. According to a report prepared by ITU in 2015, there are more than 7 billion mobile telephone subscriptions across the world, over 70% of which are in low- or middle- income countries. In many places, people are more likely to have access to a mobile telephone than to clean water, a bank account or electricity Significant technical engagement by the Secretariat towards the development and implementation of mhealth programmes, include: the joint initiative with ITU Be He@lthy Be Mobile for the prevention and management of noncommunicable diseases; the development of guidance for mhealth applications in the area of reproductive health through the mhealth Technical and Evidence Review Group for reproductive, maternal and child health; building on digital solutions to help tuberculosis patients.

36 34 SECTION FOUR

37 BE BE MOBILE Be Be Mobile

38 36 SECTION FOUR mhealth challenges Suffering from pilotitis many small-scale mhealth pilot and research studies Programs not designed for sustainability or SCALE Leads to fragmented evidence base

39 BE BE MOBILE 37 Be Be Mobile was created in 2012 to address these challenges and opportunities and help countries scale up national mhealth programs for NCD prevention and management

40 38 SECTION FOUR BHBM Objectives Mission: Save lives and improve the world s health through digital. 1. Help committed countries build, scale, sustain digital health programmes. 2. Develop content that works 3. Enter into meaningful partnerships 4. Explore and expand innovations

41 BE BE MOBILE 39 WHO Mission The attainment by all peoples of the highest possible level of health. WHO Strategic Priorities Health coverage 1 billion more people covered Health emergencies 1 billion more people safe Health priorities 1 billion lives improved BHBM contribution to strategic priorities Digital platforms, digital content, digital programmes to reach these 3 billion people

42 40 SECTION FOUR Our impact is more than just numbers Program Planning Technology Solutions Digital Health National Health BHBM Handbooks & Content Digital platforms for NCDs Digital Programme for NCDs National NCD prevention & management support Health system reinforced and strengthened Happy and healthy citizens lives saved Improved GDP of country

43 BE BE MOBILE 41 Health System Individual citizens Country s Economy

44 42 SECTION FOUR Joint UN program between WHO and ITU Looks at SCALE: institutionalising mhealth tools Inter-UN, multisectoral structure

45 BE BE MOBILE 43 Builds country capacity for innovation management in mhealth and digital health care Develops validated content

46 44 SECTION FOUR Be Be Mobile Programme Develop best practices for mhealth at scale in 9 countries WHO-ITU build & trial technical guidance to be shared globally Cross-sectoral partnership model Sustainability models in countries RESEARCH INTERVENTIONS DEVELOP TOOLKITS SCALE OR BUILD CAPACITY IN COUNTRY

47 BE BE MOBILE Share experience quickly through knowledge and innovation hubs Explore apps, wearables for NCDs Explore cities and workplaces for NCDs EVALUATE & REFINE KNOWLEDGE INSTITUTIONALISATION, KNOWLEDGE SHARING

48 46 SECTION FOUR The three pillars of Be Be Mobile 1. Handbook development

49 BE BE MOBILE Country implementation 3. Partnerships

50 48 SECTION FIVE

51 BHBM PILLAR ONE: HANDBOOKS Pillar one: Handbook Development

52 50 SECTION FIVE The end-user is the starting point in the handbook development process Be Be Mobile has borrowed from the tech industry, implementing an innovative process is which end-user needs, limitations and context are given extensive attention at each stage of the productdevelopment process.

53 BHBM PILLAR ONE: HANDBOOKS 51 What is an mhealth handbook? Be Be Mobile mhealth handbooks: Present all information necessary to implement an mhealth program in the form of ready-to-use options Are developed for each Be Be Mobile intervention by an informal expert group in collaboration with WHO, ITU, and other relevant stakeholders Are based on the best available evidence from the literature and experience

54 52 SECTION FIVE The evidence base: BHBM handbook foundation WHO has reviewed numerous studies and clinical trials where mhealth has been used successfully in the prevention and management of NCDs. The results of this systematic review of evidence are the basis for the BHBM handbooks.

55 BHBM PILLAR ONE: HANDBOOKS 53 Steps in designing a text messaging intervention STEP 1 Conduct formative research for insights into target audience and target health behaviours STEP 2 STEP 3 Design the text message programme Review functional outcomes and incorporate countryspecific findings from needs assessment (list examples) Review and adapt communication objectives (such as beliefs, attitudes, knowledge) and behavioural techniques (such as actions) Review and adapt the framework or algorithm for the programme (timing and frequency of messages) Adapt the message library Pre-test the text messaging programme concept and messages STEP 4 Revise the text message programme

56 54 SECTION FIVE mhealth handbook development process Each Handbook is tailored for country use during national workshops, to suit the specific needs of each country. Reviews and updates Workshop / expert consultations Drafting Group Internal, external and Partners consultation 1 2

57 BHBM PILLAR ONE: HANDBOOKS 55 Informal expert group and WHO/ITU expert review Executive Clearance and Publishing 3 4

58 56 SECTION FIVE The 5 core handbook content areas Handbook annexes also include content libraries and algorithms, templates, literature, and additional resources FIVE AREAS OF THE magein 2 Content development and adaptation 1 3 Operations management

59 BHBM PILLAR ONE: HANDBOOKS 57 G PROGRAMME 4 Technology specifications 5 Promotion and recruitment Monitoring and evaluation

60 58 SECTION FIVE The handbook content is technology agnostic and can be delivered via numerous platforms ALGORITHMS ALGORITHMS ALGORITHMS

61 BHBM PILLAR ONE: HANDBOOKS 59 mhealth Handbooks mdiabetes mtobacco Cessation mcervical Cancer mtb-tobacco mbreathefreely mageing mhypertension mactive msmartlife

62 60 SECTION FIVE mhealth handbooks by type of prevention Prevention Type What is it? Key drivers Be Be Mobile handbooks Primary (Wellness) Primary prevention avoids the development of disease collect data, identify patients, increase awareness, calculate risk, effective promotion, improve enrolment and change mtobacco- Cessation mdiabetes msmartlife mactive mhypertension Secondary (Diagnostics) Secondary prevention activities are aimed at early disease detection and treatment Stratify risk, target at risk groups, change attitudes, increase uptake and streamline follow-up mcervical Cancer mdiabetes mhypertension mbreathe- Freely Tertiary (self-care) Tertiary prevention reduces the negative impact of an already established disease Help patients take charge of managing their condition through improved understanding, recording/ monitoring, adherence to treatment, sharing of information mdiabetes mtb-tobacco mageing mbreathe- Freely

63 BHBM PILLAR ONE: HANDBOOKS 61 Country implementation of a handbook: a learning cycle 6. Country shares results 1. Handbook developed 2. Country requests 5. Country implements 4. Experts review 3. Country adapts

64 62 SECTION FIVE mhealth for Tobacco Cessation

65 BHBM PILLAR ONE: HANDBOOKS 63

66 64 SECTION FIVE mhealth for Diabetes

67 BHBM PILLAR ONE: HANDBOOKS 65

68 66 SECTION FIVE Digital Service Platform for Hypertension

69 BHBM PILLAR ONE: HANDBOOKS 67

70 68 SECTION SIX

71 BHBM PILLAR TWO: COUNTRIES Pillar two: Countries

72 70 SECTION SIX Be Be Mobile Programmes

73 BHBM PILLAR TWO: COUNTRIES 71 Be Be Mobile is currently working in 10 countries, and has received requests for support from more than 90 more Burkina-Faso Costa Rica Egypt India Norway Philippines Senegal Tunisia United Kingdom Zambia

74 72 SECTION SIX Country India Philippines Senegal Zambia Egypt Selected mhealth programme and achievements mtobaccocessation has ~2.1 million users as of Q1, Full scale program evaluation (May 2017) showed 6 month quit rate at ~ 7%. Program to introduce new languages and IVRS. MoH added mdiabetes program within 6 months of launch of the mcessation program. Will introduce maging and mtb/ Tobacco program in Launch of mtobaccocessation and tobacco quitline took place in June mramadan 2017 had ~ 117,834 diabetic patients and ~5000 health care providers. The program has consistently seen an increase in subscriber base since its launch in Results from biometric evaluation indicate that SMSs have positively influenced control of diabetes in the intervention group. mcervicalcancer national program launched in October 2016 by the First Lady. 600,000 clients received text messages on cervical cancer on the launch day. Since Feb 2017, SMS have been sent to 500,000 men and women in Lusaka province. Program being developed as a continumm of care model for cervical cancer. mramadan program (April 2016) reached out to to 50,000 people with diabetes edition reached out to 180,000 diabetics. mtb-tobacco program to be launched in 2018.

75 BHBM PILLAR TWO: COUNTRIES 73 Costa Rica Tunisia UK Norway Burkina Faso National platform set up and sharing experiences with regional counterparts mtobaccocessation service launched nationally in December, 2017 and has more than users as of Q1, mdiabetes under design. Looking at digital hypertension and the process for scaling digital health in government systems. BHBM activities are linked to the national program on Continued Chronic Healthcare (CCH), a broad program including services for COPD. Four different COPD systems are being trialled to show remote support can be helpful. Setting up a program for mtobaccocessation and mcervicalcancer

76 74 SECTION SIX Example of a country mhealth management team - WHO, ITU, and informal expert group Group of ageing and mhealth experts to assist in drafting the handbook and advising on implementation International mageing steering committee With representatives from the ministries of health and telecommunications and national and international representatives of WHO and ITU, to decide the overall direction and agreements National technical advisory group Government sectors (including health, telecommunications, business, media, treasury and planning) to set up the legal, technical and financial framework for a sustainable programme. This group will network with a large group of potential partners such as the telecommunications and software industry, local telcoms and mobile network providers, nongovernmental organizations, health professionals, academic and research organizations, health insurance groups, health service providers, civil society groups, opinion leaders, the media and others as appropriate National operations, content, promotion, technology, and monitoring and evaluation project leaders (subset of the TAG) Operations Content Promotion Technology Monitoring and Evaluation Management of overall programme operations, including needs assessment, workplan, budget and legal aspects Development and adaptation of the content of the intervention Management of recruitment, communications, marketing and dissemination Management of technical aspects of programme development and implementation Management of the development and implementation of monitoring and evaluation plans

77 BHBM PILLAR TWO: COUNTRIES 75 Estimated timeline to implement an mhealth program Task Year 1 Year 2 TAG formation Stakeholder engagement Needs assessment x x Resource assessment x x Creation of target population database Refinement of SMS content and delivery algorithm mhealth program pilot testing Refinement of target population and intervention Implementation of mhealth intervention Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 x x x x x x x x x x Monitoring and evaluation x x x

78 76 SECTION SIX Logic model to evaluate an mhealth program PERSON CENTERED DOMAIN INPUT OUTPUT OUTCOME IMPACT Outgoing messages Incoming messages Surveys, Interviews Reach and registration Information about the user population Ease of understanding messages Improved literacy/ knowledge/ outreach Behavior change Return on investment Technology performance Improved health outcome Improved use of resources PROGRAM CENTERED DOMAIN INPUT OUTPUT OUTCOME IMPACT Governance Policy data Resources (Finance, Human resources, ICT architecture Coverage of intervention Intervention quality Interoperability Integration with health systems Improved health literacy Access to intervention Improved health outcomes (SDG 3) Improved digital capacity (SDG 9) Efficiency & efficacy Content development Outreach and promotion Data from Person centered domain

79 BHBM PILLAR TWO: COUNTRIES 77 Case study: mtobacco Cessation in India About Half of the tobacco users in India want to quit (GATS). Limited face to face counselling facilities. High interest and commitment in the under Digital India initiative.

80 78 SECTION SIX mtobacco Cessation in India: current status National services launched in Jan 2016 as part of Prime Ministers Digital India Initiative Innovative registration method Real time data dashboard 2.2 Million users registered as of Nov The initiative is listed in the top 100 innovations of the Prime Minister's Office mdiabetes launched within 6 months, using same platform mageing and mtb-tobacco expected in 2018 Full-scale program evaluation completed in May 2017 showed the effective 6 month quit rate at 7.2% (7.2 % of users who subscribed to the program were able to quit tobacco use at 6 months).

81 BHBM PILLAR TWO: COUNTRIES 79 Example mtobacco Cessation messages Day 1 Day 10 Day 15 (1) Day 15 (2) Trigger words e.g CRAVE Welcome to the programme! Congratulations on your decision to quit smoking. To opt out at any time, text STOP to this phone number. It has been 9 days since you quit smoking. Congratulations! How are you feeling today? Text back: GOOD, OK, or BAD You are on the right track! Quitting smoking is hard but stay confident. You can do this. Your kids can get sick from secondhand smoke. It sinks into lungs, eyes, and skin. Think again before you smoke. We know how you are feeling. Think about what you are gaining and why you want to quit smoking. Stay focused. It will get easier.

82 80 SECTION SIX mtobacco Cessation user journey

83 BHBM PILLAR TWO: COUNTRIES 81

84 82 SECTION SIX Case Study: mhealth in Senegal First phase SMS messages sent during Ramadan to help diabetics manage their diabetes High visibility and engagement at the population level Second phase Three tracks: Prevention (general population risk awareness) Management for diabetics Health care worker training

85 BHBM PILLAR TWO: COUNTRIES 83 Adapting mdiabetes for Ebola Senegal used mdiabetes partnerships and platform to encourage people to alert health authorities of anyone showing signs of a fever and bleeding by calling a toll-free number. Messages were shared ahead of large-scale public events, including football matches and rallies. Senegal s SMS Ebola campaign was rolled out at top speed thanks to the existing collaboration among stakeholders created by the mdiabetes platform. As part of a massive public awareness effort, Senegal s Ministry of Health sent 4 million SMS messages to the general public warning of the dangers of Ebola and how to prevent it

86 84 SECTION SIX Case Study: mdiabetes in Egypt Egypt used the mdiabetes handbook and experience from Senegal s mdiabetes program to launch their initiative The mdiabetes program in Egypt was launched in November, 2015 as a national application of the global mhealth initiative. BE HE@LTHY BE MOBILE A handbook on how to implement mdiabetes

87 BHBM PILLAR TWO: COUNTRIES 85 Example mdiabetes messages Day 1 Day 2 Day 3 Day 4 Day 5 Walking is the best physical activity for good health. Healthy diet, regular exercise and regular medication are the 3 main pillars of blood sugar control Soft drinks contain lots of sugar; avoid them! 30 mins a day and 5 days in a week of walking or cycling or any activity which increase your breathing is healthy for a person To find out more about any of these messages, visit [govt website]

88 86 SECTION SIX mdiabetes user journey (customised for user groups)

89 BHBM PILLAR TWO: COUNTRIES 87

90 88 SECTION SIX Case Study: mcervical Cancer in Zambia National launch by the First Lady of Zambia took place in October 2016 The objective of the initial phase of mcervicalcancer program is to increase awareness on cervical cancer prevention via the use of SMS, thereby increasing demand and uptake of screening services among women in Zambia.

91 BHBM PILLAR TWO: COUNTRIES 89 Women should not die from highly preventable diseases such as cervical cancer due to lack of access to information. We are excited that Zambia will be launching the mcervicalcancer program, the first in the world. mcervicalcancer will enable women in hard to reach areas of Zambia have access to life-saving information Her Excellency, Mrs Esther Lungu, First Lady of the Republic of Zambia

92 90 SECTION SIX

93 BHBM PILLAR TWO: COUNTRIES 91 Example mcervicalcancer messages Monday Thursday Sunday Health Fact! Did you know that Cervical Cancer is the most common cancer in Zambia? Women 25 years and above should come for screening at your nearest clinic. Health Fact! Human Papillomavirus is the main cause of early changes on the cervix that lead to cervical cancer if left untreated. Get screened! Health Fact! Healthy looking women may have changes on the womb without knowing. These changes are treatable. Get screened for Cervical Cancer!

94 92 SECTION SIX mcervicalcancer user journey Woman aged between receives SMS inviting her to join the program She self-enrols by sending an SMS to the number She is around for her children and her children s children The screening finds she has very early symptoms and treats her for them

95 BHBM PILLAR TWO: COUNTRIES 93 She receives SMS every day for 2 weeks with different information on how a cervical cancer screening could save her life and inviting her to a free screening At least one of the SMS makes her think of her family and friends and how they need her She goes to a nearby clinic for screening

96 94 SECTION SEVEN

97 BHBM PILLAR THREE: PARTNERSHIPS Pillar three: Partnerships

98 96 SECTION SEVEN Be Be Mobile s multi-sectoral partnership approach is designed to engage partners whose skill sets match the needs of the global initiative or country-level work in technology, health, governance and innovations management. By approaching mhealth from an ecosystems perspective, the aim is for programs to be more sustainable as they are less vulnerable to shifts in the broader mhealth landscape.

99 BHBM PILLAR THREE: PARTNERSHIPS 97 The mhealth ecosystem HEALTH CARE PROVIDER S DIGITA L GENOMICS AI & DATA CORPORAT E WELLNES S PLATFORM S STARTUPS ACCELERATO RS HEALTH INSURANC E EMPLOY EE ENGAGEMENT PLATFORM S PHARMA TELECO MS DIGITA L HEALTH VC FUND S GLOBAL ECOMMERC E PLATFORM S OTHERS ELECTRONIC S & DEVICE S BANKIN G FOUNDATION S TECHNOLOGY GLOBAL EDUCATIONA L PLATFORM S GLOBAL DEVELOPMEN FUND S T SMAR T CITIES & INFRASTRUCT. GLOBAL DIGITA L CONSULTANC Y Ne w care provisio n New engagement platform s Ne w funding models New sustainability framew orks

100 98 SECTION SEVEN Be Be Mobile is a unique initiative in that it adopts a multi-sector partnership structure and engages country partners and governments to maximize success. Funding Intellectual property Technology Recruitment Marketing Knowledge Private Sector: Telecoms, Insurance, Pharma, Wellness, IT Government Running programmes Knowledge Content Funding Communication & promotion Governance Policy & strategy Technology M&E Convening Policies UN NGOs, Civil Society, Philanthropies Academia Content Communication & advocacy Best practices Knowledge

101 BHBM PILLAR THREE: PARTNERSHIPS 99 Be Be Mobile partners Private Sector Country governments NGOs, Civil Society, Academia, Philanthropies

102 100 SECTION SEVEN Why partners are so important Knowledge and data sharing Funding support Private Sector: Telecoms, Insurance, Pharma, Wellness, IT Public relations, communications and advocacy UN Country-specific support

103 BHBM PILLAR THREE: PARTNERSHIPS 101 Co-creation of new tools and programs Government Provision of products and services NGOs, Civil Society, Philanthropies Academia Global advocacy and leadership Technical Expertise

104 102 SECTION SEVEN BHBM is an opportunity for learning and innovation Egypt is learning from Senegal Zambia is utilizing existing screening capacity India is adapting content and adding services on their national digital platform Senegal used their infrastructure and network with telecoms to send messages to rural areas during Ebola crisis BHBM informal expert groups and partners are learning from country experiences

105 BHBM PILLAR THREE: PARTNERSHIPS Global Consultation on Lessons Learned

106 104 SECTION EIGHT

107 BHBM PROGRAMME RESULTS Be Be Mobile programme results

108 106 SECTION EIGHT Phase 1 achievements ( ) Nomination for a sustainable business award (May 2015) WHO DG Award for Excellence (March 2016) Programmes in 10 countries 3 toolkits published (mtobaccocessation, mdiabetes, mcervicalcancer) and 4 under development Partnerships/collaborations with 10 countries and over 18 international organizations

109 BHBM PROGRAMME RESULTS 107

110 108 SECTION EIGHT Be Be Mobile country results INDIA, mtobacco Cessation: Effective 6 month quit rate ~ 7%* *respondents who after 6 months of being enrolled in the program reported that they did not use tobacco in the last 30 days and had read the mcessation messages INDIA, mdiabetes: Full scale evaluation of the program indicated that mobile technology has the potential to positively change behaviour in the context of diabetes, and serve as an enabler to reach a large number of people in a short time with minimum effort and cost

111 BHBM PROGRAMME RESULTS 109 ZAMBIA, mcervical Cancer: ~ 6% increase in first time screens* *attributable to the mcervical Cancer program; preliminary data collated from 12 out of 19 clinics in Lusaka province between the period of Feb- July 2017 SENEGAL, mdiabetes: Results of a biometric evaluation indicate that sending SMS was associated with an improvement in glycaemic control in people with type 2 diabetes

112 110 SECTION EIGHT BMJ Innovations special edition on digital health and innovation First international interdisciplinary journal focused on innovations BHBM special issue on digital health and innovation, including country results Publication date in mid 2018

113 Staying in touch: monthly postcards BHBM PROGRAMME RESULTS 111

114 112 SECTION NINE

115 BHBM PROGRAMME INNOVATIONS Be Be mobile programme innovations

116 114 SECTION NINE Talking Book Partnership between Literacy Bridge BHBM, ARM Provides health messaging orally Funded for pilot testing in Gabon Features: Speaker for group listening Speakers the local language Updated and monitored over USB Mic for user feedback Embossed for use in the dark or when blind

117 BHBM PROGRAMME INNOVATIONS 115 Robust tablet for health care workers in LMICs Partnership between WHO, DFID, ARM Currently in development

118 116 SECTION NINE mhealth Knowledge & Innovation Hub ( ) Objective of hub Scale-up mhealth services Compile best practices Focus innovation around key needs and gaps Structure Jointly managed by WHO, ITU & EC Three-year project with: Hub selection Set-up Scale-up National and international experiences solicited

119 BHBM PROGRAMME INNOVATIONS 117 Core Functions HUB Operational research Implementation support and consulting Train and educate Identify standards, regulatory and policy gaps

120 118 SECTION NINE mhealth Knowledge and Innovation Hub EU Project Four year project funded by the Horizon 2020 Program ( Work Programme) 1st March th February 2021 ITU and WHO are Partners

121 BHBM PROGRAMME INNOVATIONS 119 Objectives: Establish an EU mhealth Hub for collecting and disseminating research and experience relating to large-scale implementations of mhealth programs Build capacity for the Hub to be able to support Member States in implementing national mhealth programs

122 120 SECTION NINE European Community expected impact of the project 1.Creating evidence on health outcomes, quality of life and care efficiency gains in the NCD management by using mhealth solutions. 2.Enabling mhealth to be deployed in national and regional level health services and to deliver largescale benefits, first of the selected entities, and later in the rest of Europe. 3.Becoming the focal point for expertise on mhealth in the EU and identifying and highlighting trends and gaps in policies, standards, regulations, etc. and best practices and barriers to the creation of consistent mhealth infrastructure and strategy. 4.Unique platform to support innovation in and up-scaling of mhealth by convening cross sector stakeholders (young entrepreneurs, start-ups, governments, technical officers etc.). 5.Creating synergies with the existing EU platforms of stakeholders such as ehealth network of Member States and also the EU EIP on Active and Healthy Ageing (requirement, scope, impact).

123 BHBM PROGRAMME INNOVATIONS 121 Beyond the EU project Use as a model for regional mhealth Hubs Strengthen regional/local context for mhealth Network of Hubs Strengthen Be He@lthy Be Mobile outreach and knowledge base Will have to balance local role and relationship to other regional mhealth stakeholders with relationship to network of Hubs and relationship with ITU and WHO Avoid becoming another project and pilots operator

124 122 SECTION NINE ehealth: Harnessing technology on the road towards universal health coverage An example is the initiative Be Be Mobile, which promotes the use of mobile technology to help Member States combat the growing burden of noncommunicable diseases Carissa F. Etienne Director, Regional Office of the World Health Organization for the Americas, Washington, D.C., United States of America

125 BHBM PROGRAMME INNOVATIONS 123 The WHO ITU joint initiative on mhealth for NCDs is a promising innovative intervention to see how to use new technologies to better health outcome" Helen Clark Former UNDP Administrator (31 January 2013) Harvard School Public Health, Boston, Massachusetts

126 For more information, please contact: or

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